During the last decennium, uridine, choline and omega-3 fatty acids such as DHA have attracted attention as active components in treating cognitive dysfunction and age-associated memory impairment (AAMI). These compounds are rate-limiting precursors for membrane phosphatide synthesis.
WO2007/089703 (Massachusetts Institute of Technology) discloses uridine for treating AAMI, hippocampal dysfunction, memory disorders and brain damage, comprising a composition comprising uridine. In one embodiment, the composition comprising the uridine has a lipid fraction comprising docosahexaenoic acid, eicosapentaenoic acid, docosapentaenoic acid, or a combination thereof. Other than fish oil, the fat fraction is left unspecified. In one embodiment, this publication discloses a composition comprising UMP, choline, fish oil, carbohydrate and milk protein, without linking it to a particular neurological disorder.
WO 2009/059306 (Massachusetts Institute of Technology) provides a method of evaluating a subject's compliance with a uridine dietary supplementation regimen, using magnetic resonance imaging (MRI). Dietary supplementation may further include choline and omega-3 fatty acids such as DHA. This publication is concerned with measuring brain cytidine levels, but does not provide any treatment in itself.
WO 2009/002165 (N.V. Nutricia) discloses a lipid fraction for improving brain function. The focus is on neurological disorders such as Alzheimer's disease and decrease in cognitive function, in which case the composition may further comprise UMP. The lipid composition involves a specific ratio of medium-chain fatty acids hexanoic acid and octanoic acid, and furthermore comprises DHA and EPA. There should be more than 0.4 g alpha-linolenic acid per 100 g fatty acids present. Additionally, this publication teaches that the amount of the sum of C6:0+C7:0+C8:0 fatty acids to the sum of C9:0+C10:0 is at least 2.5:1.
WO 2007/073178 (N.V. Nutricia) discloses a composition comprising a) DHA, DPA and/or EPA in combination with b) a protein fraction providing cysteine and/or taurine, and c) a mineral fraction comprising at least one of manganese and molybdenum, for use in the treatment of neurological disorders, improvement of function of nerve cells, decrease in the formation of plaques, neuropathies, and the improvement of function of the nerve system. Uridine and choline are listed as further components.
The effect of a medical food containing a cocktail of DHA/EPA, uridine, choline, phospholipids and vitamins B, C and E such as disclosed in WO 2007/073178 as mentioned above on cognitive function was investigated in a clinical trial with people with mild Alzheimer's disease. The results are reported in Scheltens et al., Alzheimer's & Dementia 6 (2010), 1-10. Significant improvement in the delayed verbal recall task was noted.
Where a medical nutrition is developed in the prior art to prevent and treat dementia syndromes and cognitive dysfunction associated therewith, less attention has been drawn to another class of neurological disorders, i.e. those caused by neurotrauma. Neurotrauma involves traumatic injury to either the brain or spinal cord. Neurological trauma causes thousands of deaths and devastating irreversible tragedies annually. Because it afflicts many otherwise perfectly healthy young people, the productive years lost as a result of its ravages are particularly high. Although these neurological disorders share many of the concepts underlying neurodegenerative mechanism also observed for dementia syndromes, there are specific problems associated with the target group of patients.
The problem to be solved is related to the abilities of a patient which suffers from SCI, CP or neurotrauma and the clinical need to improve the recovery of function of the injured nervous tissue after the damage was done. The patient may have difficulties consuming a nutritional product properly (due to partial paralysis of muscles needed for consumption) and many patients suffering from the symptoms from SCI or neurotrauma will experience volume restrictions, loss of appetite and a disturbed taste sensation. It is also a problem to such patient that their activities of daily living, for example their capabilities to use the bathroom are limited. It is therefore a purpose of the invention to solve at least one of these problems and preferably at least 2 or even 3 of these problems simultaneously.
It is noted that merely eliminating (nutritional) ingredients from the nutritional composition taught in the art for treating AD patients may result in a low-volume dosage form, but unfortunately at the cost of the neurodegenerative effect. It is suboptimal to lower the amounts of the active ingredients to meet volume criterions. The art thus searches for other solutions.